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Randomized Controlled Trial
. 2013 Apr;36(4):978-84.
doi: 10.2337/dc12-0227. Epub 2012 Dec 10.

Primary prevention of macroangiopathy in patients with short-duration type 2 diabetes by intensified multifactorial intervention: seven-year follow-up of diabetes complications in Chinese

Yu Yang  1 , Jun-jie Yao, Jian-ling Du, Ran Bai, Li-peng Sun, Guo-hua Sun, Gui-rong Song, Si-ming Cao, Chun-hong Shi, Ying Ba, Qian Xing, Xue-yang Zhang
Affiliations
Randomized Controlled Trial

Primary prevention of macroangiopathy in patients with short-duration type 2 diabetes by intensified multifactorial intervention: seven-year follow-up of diabetes complications in Chinese

Yu Yang et al. Diabetes Care. 2013 Apr.

Abstract

Objective: To explore whether intensified, multifactorial intervention could prevent macrovascular disease in patients with recently diagnosed type 2 diabetes.

Research design and methods: A total of 150 type 2 diabetic patients, with disease duration of <1 year and without clinical arteriosclerotic disease or subclinical atherosclerotic signs confirmed by ultrasonographic scanning of three conducting arteries, were randomized into an intensive intervention group and a conventional intervention group. They then received intensive, multifactorial intervention or conventional intervention over 7 years of follow-up. The patients' common carotid intima-media thicknesses (CC-IMTs) were measured every year. The primary outcome was the time to the first occurrence of CC-IMTs ≥1.0 mm and/or development of atherosclerosis plaques in the carotid artery. The secondary outcome was clinical evidence of cardiovascular disease.

Results: A total of 70 patients in the intensive group and 68 patients in the conventional group completed the 7-year follow-up. Subclinical macrovascular (primary) outcomes occurred in seven cases in the intensive group and 22 cases in the conventional group for a cumulative prevalence of 10.00 and 32.35%, respectively (P < 0.05). No significant differences between the two groups were observed regarding the secondary outcome.

Conclusions: Primary prevention of macrovascular diseases can be achieved through intensified, multifactorial intervention in patients with short-duration type 2 diabetes. Type 2 diabetic patients should undergo intensive multifactorial interventions with individual targets for the prevention of macrovascular diseases.

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Figures

Figure 1
Figure 1
Enrollment and outcomes.
Figure 2
Figure 2
Comparison of the prevalence of macrovascular end events in every follow-up year. A: Comparison of the prevalence of final subclinical macrovascular end points. B: Comparison of the prevalence of final clinical macrovascular events. CG, conventional group; IG, intensive group. *Compared with the conventional group, P < 0.05.
See this image and copyright information in PMC

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